内蒙古地区心血管病高危人群发生冠状动脉粥样硬化性心脏病的危险因素

苗宇; 闫涛; 张子英; 郭淑怡; 王靖宇; 闫金利; 许蕾; 王雅; 张春发; 钟武志; 张楠; 张星光

doi:10.16462/j.cnki.zhjbkz.2024.03.010

内蒙古地区心血管病高危人群发生冠状动脉粥样硬化性心脏病的危险因素

doi: 10.16462/j.cnki.zhjbkz.2024.03.010

苗宇¹,
闫涛¹,
张子英²,
郭淑怡³,
王靖宇¹,
闫金利¹,
许蕾¹,
王雅¹,
张春发¹,
钟武志¹,
张楠^4, ,,
张星光^1, ,

1.
内蒙古医科大学公共卫生学院卫生统计学教研室，呼和浩特 010110
2.
内蒙古医科大学基础医学院药理学教研室，呼和浩特 010110
3.
内蒙古自治区人民医院应急管理科，呼和浩特 010110
4.
内蒙古医科大学公共卫生学院卫生检验与检疫学教研室，呼和浩特 010110

基金项目:

国家自然科学基金 82160639

内蒙古自治区高等学校青年科技英才支持计划 NJYT22008

内蒙古医科大学心血管病分子流行病学及防治研究科技创新团队项目 YKD2022TD015

内蒙古医科大学学科建设项目 YKD2022XK012

详细信息

通讯作者:
张星光，E-mail：zxg311@126.com

张楠，E-mail：17704713193@163.com

中图分类号: R181.1;R714.252
计量
- 文章访问数: 34
- HTML全文浏览量: 8
- PDF下载量: 9
- 被引次数: 0
出版历程
- 收稿日期: 2023-10-08
- 修回日期: 2024-01-06
- 网络出版日期: 2024-04-08
- 刊出日期: 2024-03-10

Analysis of the risk factors of coronary heart disease in population at high cardiovascular risk in Inner Mongolia

1.
Department of Statistics, School of Public Health, Inner Mongolia Medical University, Hohhot 010110, China
2.
Department of Pharmacology, School of Basic Medicine, Inner Mongolia Medical University, Hohhot 010110, China
3.
Department of Emergency Management, Inner Mongolia Autonomous Region People′s Hospital, Hohhot 010110, China
4.
Department of Health Laboratory Science, School of Public Health, Inner Mongolia Medical University, Hohhot 010110, China

Funds:

National Natural Science Foundation of China 82160639

Young Talents of Science and Technology in Universities of Inner Mongolia Autonomous Region NJYT22008

Scientific and Technological Innovation Team of Cardiovascular Molecular Epidemiology and Prevention Research, Inner Mongolia Medical University YKD2022TD015

Discipline Construction Project of Inner Mongolia Medical University YKD2022XK012

More Information

Corresponding author: YI ZHANG Nan, E-mail: 17704713193@163.com; ZHANG Xingguang, E-mail: zxg311@126.com

摘要

摘要: 目的探讨内蒙古地区心血管病高危人群冠状动脉粥样硬化性心脏病(coronary heart disease，CHD)发病的相关危险因素，为制定适合内蒙古地区CHD的防治策略提供科学依据。方法采用前瞻性队列研究方法，利用多阶段分层整群抽样方法。于2015年12月在内蒙古地区6个盟市开展调查，每年随访1次，直至2021年12月。基线调查包括一般情况、疾病史及治疗史、体格检查和实验室检测，随访调查包括心血管健康状况及临床终点事件收集。采用Cox回归模型分析影响CHD的发病因素。结果最终纳入37 726名研究对象，多因素Cox回归模型分析表明：增龄(HR>1.00, P < 0.001)、吸烟(HR=1.20, P < 0.001)、饮酒(HR=1.41, P < 0.001)、超重或肥胖(HR=1.19, P < 0.001)、高血压(HR=1.41, P < 0.001)、糖尿病(HR=1.22, P < 0.001)、血脂异常(HR=2.20, P < 0.001)为CHD发病的危险因素；高教育水平(HR < 1.00, P < 0.001)、非重体力劳动类型(HR < 1.00, P < 0.001)为CHD发病的保护因素。结论在内蒙古地区，增龄、吸烟、饮酒、血脂异常、高血压、糖尿病、超重或肥胖为CHD发病的危险因素，高教育水平、非重体力劳动为CHD发病的保护因素。
- 冠状动脉粥样硬化性心脏病 /
- 影响因素 /
- 高危人群 /
- 队列研究
Abstract: Objective To explore the related risk factors of coronary heart disease (CHD) in the population at high risk of cardiovascular disease in Inner Mongolia, and to provide scientific basis for the development of prevention and treatment strategies for CHD in Inner Mongolia. Methods This study was a prospective cohort study, the study population was selected by multi-stage stratified cluster sampling method. A survey was conducted in six cities in Inner Mongolia region from December 2015, and the follow-up survey was conducted once a year until December 2021. The baseline survey included general information, disease and treatment history, physical examination and laboratory tests. The follow-up survey included cardiovascular health status and clinical endpoint events. Cox regression model was used to analyze the risk factors of CHD. Results A total of 37 726 subjects were finally included in this study, multivariate Cox regression analysis showed that: increasing age (HR>1.00, P < 0.001), smoking (HR=1.20, P < 0.001), drinking (HR=1.41, P < 0.001), overweight or obesity (HR=1.19, P < 0.001), hypertension (HR=1.41, P < 0.001), diabetes (HR=1.22, P < 0.001) were dyslipidemia (HR=2.20, P < 0.001) were risk factors for CHD. In contrast, high education level (HR < 1.00, P < 0.001) and non-heavy physical labor type (HR < 1.00, P < 0.001) were protective factors for CHD. Conclusions In Inner Mongolia, increasing age, smoking, drinking, dyslipidemia, hypertension, diabetes, overweight or obesity are risk factors for CHD, high education level and non-heavy physical labor type are protective factors for CHD.
- Coronary heart disease /
- Influencing factors /
- High-risk population /
- Cohort study

HTML全文

图 1 不同年龄段人群CHD累计发病率曲线

CHD, 冠状动脉粥样硬化性心脏病。

Figure 1. Cumulative incidence curves of CHD in different age groups

CHD, coronary heart disease.

下载: 全尺寸图片幻灯片

表 1 研究对象的一般特征

Table 1. Baseline characteristics of the participants

变量Variable	男性 ^① Male ^①	女性 ^① Female ^①	合计 ^① Total ^①	χ²值value	P值value
年龄组/岁Age group/years				89.85	＜0.001
35~＜45	1 952(11.9)	1 951(9.2)	3 903(10.3)
45~＜55	4 815(29.3)	6 443(30.2)	11 258(29.8)
55~＜65	5 996(36.5)	8 352(39.2)	14 348(38.1)
≥65	3 652(22.3)	4 565(21.4)	8 217(21.8)
民族Ethnicity				2.56	0.278
汉族Han	14 756(89.9)	19 255(90.3)	34 011(90.2)
蒙古族Mongol	1 463(8.9)	1 826(8.6)	3 289(8.7)
其他民族Others	196(1.2)	230(1.1)	426(1.1)
劳动类型Labor type				794.95	＜0.001
重体力劳动Heavy physical	7 800(47.5)	9 685(45.5)	17 485(46.3)
失业、家务或退休Unemployment, housework or retirement	4 115(25.1)	7 828(36.7)	11 943(31.7)
其他非重体力劳动Other non-heavy physical	4 500(27.4)	3 798(17.8)	8 298(22.0)
血脂异常Dyslipidemia	2 079(12.7)	4 539(21.3)	6 618(17.5)	477.83	＜0.001
高血压Hypertension	13 764(83.9)	17 572(82.5)	31 336(83.1)	12.83	＜0.001
糖尿病Diabetes	4 279(26.1)	4 947(23.2)	9 226(24.5)	40.89	＜0.001
吸烟Smoking	8 102(49.4)	1 461(6.9)	9 563(25.3)	8 851.66	＜0.001
饮酒Drinking	4 277(26.1)	347(1.6)	4 624(12.3)	5 144.70	＜0.001
食用畜肉Eating meat				125.13	＜0.001
从不或几乎不Never or almost never	672(4.1)	1 263(5.9)	1 935(5.1)
偶尔或每周＜4次Occasionally or＜4 times per week	8 276(50.4)	11 366(53.3)	19 642(52.1)
每天或几乎每天Every day or almost every day	7 467(45.5)	8 682(40.8)	16 149(42.8)
食用乳制品Eating dairy				10.15	0.006
从不或几乎不Never or almost never	5 967(36.3)	7 928(37.2)	13 895(36.8)
偶尔或每周＜4次Occasionally or＜4 times per week	7 200(43.9)	9 003(42.2)	16 203(43.0)
每天或几乎每天Every day or almost every day	3 248(19.8)	4 380(20.6)	7 628(20.2)
教育水平Educational level				1 546.24	＜0.001
小学及以下Primary school and below	4 591(28.0)	9 998(46.9)	14 598(38.7)
中学及中专Secondary school	9 462(57.6)	9 717(45.6)	19 179(50.8)
大学及以上University and above	2 362(14.4)	1 596(7.5)	3 958(10.5)
家庭年收入/万元Annual household income/ten thousand yuan				250.49	＜0.001
＜1	3 211(19.6)	5 248(24.6)	8 459(22.4)
1~5	8 383(51.1)	11 143(52.3)	19 526(51.8)
＞5	4 821(29.3)	4 920(23.1)	9 741(25.8)
体育锻炼Physical exercise				3.32	0.190
从不或几乎不参加Never or almost never	9 680(58.9)	12 442(58.4)	22 122(58.7)
偶尔或每周＜5次Occasionally or＜5 times per week	2 146(13.1)	2 921(13.7)	5 067(13.4)
每天或几乎每天都锻炼Every day or almost every day	4 589(28.0)	5 948(27.9)	10 537(27.9)
BMI				41.44	＜0.001
低或正常体重Low or normal	3 919(23.9)	5 709(26.8)	9 628(25.5)
超重或肥胖Overweight or obesity	12 496(76.1)	15 602(73.6)	28 098(74.5)
注：①以人数(占比/%)表示。 Note: ① Number of people(proportion/%).

下载: 导出CSV

表 2 CHD发病影响因素的Cox回归模型分析

Table 2. Cox regression analysis of the influencing factors of CHD

变量Variable	总人群Total Population		性别Gender
	总人群Total Population		男Male		女Female
	HR值value(95% CI)	P值value	HR值value(95% CI)	P值value	HR值value(95% CI)	P值value
性别Gender
女Female	1.00
男Male	1.16(1.03~1.31)	0.015
年龄组/岁Age group/years
35~＜45	1.00		1.00		1.00
45~＜55	1.64(1.23~2.19)	0.001	1.84(1.21~2.80)	0.004	1.46(0.97~2.18)	0.068
55~＜65	2.91(2.20~3.85)	< 0.001	3.25(2.17~4.86)	< 0.001	2.59(1.75~3.83)	< 0.001
≥65	3.95(2.96~5.27)	< 0.001	4.40(2.90~6.68)	< 0.001	3.52(2.36~5.26)	< 0.001
民族Ethnicity
汉族Han	1.00		1.00		1.00
蒙古族Mongol	1.11(0.92~1.34)	0.270	1.30(1.00~1.69)	0.048	0.97(0.74~1.26)	0.812
其他民族Others	1.13(0.73~1.76)	0.581	0.73(0.32~1.62)	0.435	1.46(0.86~2.47)	0.166
吸烟Smoking
否No	1.00		1.00		1.00
是Yes	1.20(1.05~1.36)	0.006	1.20(1.03~1.40)	0.022	1.24(0.98~1.56)	0.075
饮酒Drinking
否No	1.00		1.00		1.00
是Yes	1.41(1.18~1.68)	0.001	1.43(1.18~1.72)	＜0.001	1.25(0.70~2.23)	0.445
劳动类型Labor type
重体力劳动Heavy physical	1.00		1.00		1.00
失业、家务或退休Unemployment, housework or retirement	1.00(0.88~1.13)	0.945	1.04(0.86~1.26)	0.701	0.97(0.83~1.13)	0.671
其他非重体力劳动Other non-heavy physical	0.64(0.52~0.78)	< 0.001	0.71(0.54~0.92)	0.010	0.55(0.40~0.76)	＜0.001
高血压患病Hypertension
否No	1.00		1.00		1.00
是Yes	1.41(1.27~1.57)	< 0.001	1.34(1.15~1.57)	＜0.001	1.47(1.27~1.70)	＜0.001
血脂异常患病Dyslipidemia
否No	1.00		1.00		1.00
是Yes	2.20(1.68~2.88)	< 0.001	2.09(1.36~3.22)	0.001	2.28(1.61~3.23)	< 0.001
糖尿病患病Diabetes
否No	1.00		1.00		1.00
是Yes	1.22(1.06~1.41)	0.006	1.05(0.83~1.32)	0.679	1.34(1.12~1.60)	0.002
BMI/(kg·m^-2)
低或正常体重Low or normal	1.00		1.00		1.00
超重或肥胖Overweight or obesity.	1.19(1.06~1.35)	0.005	1.28(1.06~1.54)	0.010	1.12(0.95~1.32)	0.176
家庭年收入/万元Annual household income/ten thousand yuan
＜1	1.00		1.00		1.00
1~5	1.05(0.94~1.18)	0.379	1.07(0.89~1.29)	0.467	1.05(0.90~1.21)	0.553
＞5	0.99(0.83~1.18)	0.907	1.16(0.90~1.48)	0.255	0.85(0.67~1.08)	0.191
教育水平Educational level
小学及以下Primary school and below	1.00		1.00		1.00
中学及中专Secondary school	0.82(0.73~0.92)	0.001	0.77(0.64~0.92)	0.004	0.88(0.75~1.03)	0.117
大学及以上University and above	0.79(0.62~1.02)	0.069	0.77(0.56~1.05)	0.096	0.74(0.48~1.14)	0.168
注: CHD, 冠状动脉粥样硬化性心脏病。 Note: CHD, coronary heart disease.

下载: 导出CSV

参考文献(20)

[1]	王海明, 邵钧捷, 周晶晶, 等. 早发冠心病患者的临床特征及发病危险因素分析[J]. 中国心血管病研究, 2022, 20(2): 154-160. DOI: 10.3969/j.issn.1672-5301.2022.02.012. Wang HM, Shao JJ, Zhou JJ, et al. Analysis of clinical characteristics and risk factors of patients with premature coronary heart disease[J]. Chin J Cardiovasc Res, 2022, 20(2): 154-160. DOI: 10.3969/j.issn.1672-5301.2022.02.012.
[2]	中国心血管健康与疾病报告编写组. 中国心血管健康与疾病报告2019概要[J]. 中国循环杂志, 2020, 35(9): 833-854. DOI: 10.3969/j.issn.1000-3614.2020.09.001. China Cardiovascular Health and Disease Report Writing Group. Report on cardiovascular health and diseases in China 2019: an updated summary[J]. Chin Circ J, 2020, 35(9): 833-854. DOI: 10.3969/j.issn.1000-3614.2020.09.001.
[3]	曹宁, 牛丽薇, 张楠, 等. 内蒙古心血管疾病患者健康相关生活质量及其影响因素的研究[J]. 现代预防医学, 2021, 48(15): 2857-2861. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202115036.htm Cao N, Niu LW, Zhang N, et al. Health-related quality of life and its influencing factors in patients with cardiovascular disease in Inner Mongolia[J]. Modern Preventive Medical, 2021, 48(15): 2857-2861. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202115036.htm
[4]	魏国, 贺淑珍, 白华民, 等. 西乌珠穆沁旗居民慢性病现状调查分析[J]. 包头医学院学报, 2015, 31(2): 17-18. DOI: 10.16833/j.cnki.jbmc.2015.02.012. Wei G, He SZ, Bai HM, et al. The survey of chronic diseases among residents in West Ujimqin Banner[J]. Journal of Baotou Medical College, 2015, 31(2): 17-18. DOI: 10.16833/j.cnki.jbmc.2015.02.012.
[5]	Yamamoto K, Natsuaki M, Morimoto T, et al. Coronary artery disease without standard cardiovascular risk factors[J]. Am J Cardiol, 2022, 164: 34-43. DOI: 10.1016/j.amjcard.2021.10.032.
[6]	Riaz H, Khan MS, Siddiqi TJ, et al. Association between obesity and cardiovascular outcomes: a systematic review and meta-analysis of Mendelian randomization studies[J]. JAMA Netw Open, 2018, 1(7): e183788. DOI: 10.1001/jamanetworkopen.2018.3788.
[7]	Cai XY, Zhang YL, Li MJ, et al. Association between prediabetes and risk of all cause mortality and cardiovascular disease: updated meta-analysis[J]. BMJ, 2020, 370: m2297. DOI: 10.1136/bmj.m2297.
[8]	Said MA, Verweij N, van der Harst P. Associations of combined genetic and lifestyle risks with incident cardiovascular disease and diabetes in the UK biobank study[J]. JAMA Cardiol, 2018, 3(8): 693-702. DOI: 10.1001/jamacardio.2018.1717.
[9]	Xi YF, Bao H, Han K, et al. Evaluating the treatment and control of modifiable cardiovascular disease risk factors among patients with diabetes in the Inner Mongolia, China: a cross-sectional study[J]. Prev Med, 2020, 139: 106174. DOI: 10.1016/j.ypmed.2020.106174.
[10]	郭琼, 王培承, 王俊, 等. 2020年潍坊市65岁及以上老年人群冠心病患病率及危险因素分析[J]. 预防医学情报杂志, 2023, 39(7): 782-787, 796. https://www.cnki.com.cn/Article/CJFDTOTAL-YFYX202307010.htm Guo Q, Wang PC, Wang J, et al. Prevalence and risk factors of coronary heart disease in elderly population aged 65 and above of Weifang City in 2020[J]. J Prev Med lnf, 2023, 39(7): 782-787, 796. https://www.cnki.com.cn/Article/CJFDTOTAL-YFYX202307010.htm
[11]	高阅春, 何继强, 姜腾勇, 等. 冠心病患者冠状动脉病变严重程度与冠心病危险因素的相关分析[J]. 中国循环杂志, 2012, 27(3): 178-181. DOI: 10.3969/j.issn.1000-3614.2012.03.006. Gao YC, He JQ, Jiang TY, et al. Relationship of coronary stenosis severity with its risk factors in patients of coronary artery disease[J]. Chin Circ J, 2012, 27(3): 178-181. DOI: 10.3969/j.issn.1000-3614.2012.03.006.
[12]	沈有录, 刘维军, 张青. 青海地区冠心病危险因素与冠状动脉病变的相关分析[J]. 重庆医学, 2015, 44(35): 4943-4945, 4949. DOI: 10.3969/j.issn.1671-8348.2015.35.014. Shen YL, Liu WJ, Zhang Q. Correlation between coronary artery disease risk factors and characteristics of coronary artery lesions in Qinghai[J]. Chongqing Med, 2015, 44(35): 4943-4945, 4949. DOI: 10.3969/j.issn.1671-8348.2015.35.014.
[13]	Voutilainen A, Brester C, Kolehmainen M, et al. Epidemiological analysis of coronary heart disease and its main risk factors: are their associations multiplicative, additive, or interactive?[J]. Ann Med, 2022, 54(1): 1500-1510. DOI: 10.1080/07853890.2022.2078875.
[14]	Lin TH, Lee WL, Lee WJ, et al. Dyslipidemia, not inflammatory markers or adipokines, contributes significantly to a higher SYNTAX score in stable coronary artery disease (from the Taichung CAD study)[J]. Acta Cardiol Sin, 2021, 37(3): 232-238. DOI: 10.6515/ACS.202105_37(3).20201116B.
[15]	王辰, 肖丹, 池慧. 《中国吸烟危害健康报告2020》概要[J]. 中国循环杂志, 2021, 36(10): 937-952. DOI: 10.3969/j.issn.1000-3014.2021.10.001. Wang C, Xiao D, Chi H. 2020 report on health hazards of smoking in China: an updated summary[J]. Chin Circ J, 2021, 36(10): 937-952. DOI: 10.3969/j.issn.1000-3014.2021.10.001.
[16]	杨文文, 贾哲, 劳秋凤, 等. 超重或肥胖人群并发冠心病的危险因素分析[J]. 内科, 2021, 16(3): 288-291, 316. DOI: 10.16121/j.cnki.cn45-1347/r.2021.03.03. Yang WW, Jia Z, Lao QF, et al. Analysis of risk factors for coronary heart disease in overweight or obese population[J]. Intern Med, 2021, 16(3): 288-291, 316. DOI: 10.16121/j.cnki.cn45-1347/r.2021.03.03.
[17]	宋彦君. 冠心病患者PCI术后支架内再狭窄的风险因素探究及防治措施[J]. 中国医学创新, 2020, 17(20): 31-34. DOI: 10.3969/j.issn.1674-4985.2020.20.008. Song YJ. Risk factors of In-stent restenosis after PCI in patients with coronary heart disease and prevention measures[J]. Med Innov China, 2020, 17(20): 31-34. DOI: 10.3969/j.issn.1674-4985.2020.20.008.
[18]	熊家瑞, 黎明江, 黄亚敏, 等. 冠心病患者PCI术后支架内再狭窄的临床特点及危险因素分析[J]. 疑难病杂志, 2019, 18(8): 760-764. DOI: 10.3969/j.issn.1671-6450.2019.08.002. Xiong JR, Li MJ, Huang YM, et al. Clinical characteristics and risk factors of in-stent restenosis in patients with coronary heart disease after PCI[J]. Chin J Difficu Compl Cas, 2019, 18(8): 760-764. DOI: 10.3969/j.issn.1671-6450.2019.08.002.
[19]	Holtermann A, Schnohr P, Nordestgaard BG, et al. The physical activity paradox in cardiovascular disease and all-cause mortality: the contemporary copenhagen general population study with 104046 adults[J]. Eur Heart J, 2021, 42(15): 1499-1511. DOI: 10.1093/eurheartj/ehab087.
[20]	王刚, 谢伦芳, 章新琼. 老年冠心病住院患者健康素养现状及其影响因素分析[J]. 中国健康教育, 2018, 34(9): 859-861. DOI: 10.16168/j.cnki.issn.1002-9982.2018.09.024. Wang G, Xie LF, Zhang XQ. Analysis on the status of health literacy and its influencing factors among elderly patients with coronary heart disease[J]. Chin J Health Educ, 2018, 34(9): 859-861. DOI: 10.16168/j.cnki.issn.1002-9982.2018.09.024.

施引文献

资源附件(0)

访问统计

点击查看大图

图(1) / 表(2)

计量

文章访问数: 34
HTML全文浏览量: 8
PDF下载量: 9
被引次数: 0

姓名
邮箱
手机号码
标题
留言内容
验证码

留言板

内蒙古地区心血管病高危人群发生冠状动脉粥样硬化性心脏病的危险因素

doi: 10.16462/j.cnki.zhjbkz.2024.03.010

通讯作者:
张星光，E-mail：zxg311@126.com

张楠，E-mail：17704713193@163.com

计量

Analysis of the risk factors of coronary heart disease in population at high cardiovascular risk in Inner Mongolia

Corresponding author: YI ZHANG Nan, E-mail: 17704713193@163.com; ZHANG Xingguang, E-mail: zxg311@126.com

计量

目录

留言板

内蒙古地区心血管病高危人群发生冠状动脉粥样硬化性心脏病的危险因素

doi: 10.16462/j.cnki.zhjbkz.2024.03.010

通讯作者: 张星光，E-mail：zxg311@126.com 张楠，E-mail：17704713193@163.com

计量

出版历程

Analysis of the risk factors of coronary heart disease in population at high cardiovascular risk in Inner Mongolia

Corresponding author: YI ZHANG Nan, E-mail: 17704713193@163.com; ZHANG Xingguang, E-mail: zxg311@126.com

计量

出版历程

目录

通讯作者:
张星光，E-mail：zxg311@126.com

张楠，E-mail：17704713193@163.com